Journal of Nursing and Public Health Research

Effects of a Case-Based Medication Adherence Promotion Program among Uncontrolled Hypertensive Patients at a Private Hospital in Bangkok

2025-10-27T10:36:12+07:00

This quasi-experimental study with a two-group pretest–posttest design aimed to: 1) compare medication adherence scores and blood pressure levels among patients with uncontrolled hypertension before and after participation in a case management medication adherence promotion program; 2) compare medication adherence scores and blood pressure control outcomes between the experimental and control groups after the intervention; 3) compare adaptation scores based on Roy’s Adaptation Theory between the experimental and control groups after the intervention; and 4) examine patient satisfaction with the program. The sample consisted of 60 patients with uncontrolled hypertension and low medication adherence scores, divided equally into an experimental group and a control group (30 participants each) using matching and random assignment. The experimental group received a case management medication adherence promotion program developed based on Roy’s Adaptation Theory integrated with the World Health Organization’s five-dimensional adherence framework for a period of 6 weeks, with continuous support through the Line application throughout the study. The control group received standard care. Research instruments included the 8-item Morisky Medication Adherence Scale (MMAS-8), the Roy Adaptation Assessment Questionnaire, and a satisfaction questionnaire. Data were analyzed using independent and paired t-tests.

The findings revealed that, after completion of the program, the experimental group demonstrated a statistically significant increase in medication adherence scores from 3.80 to 6.40 points (p-value < 0.001), which was significantly higher than that of the control group (p-value < 0.001). The experimental group also achieved a mean reduction in systolic blood pressure of 19.70 mmHg, and 70% of participants achieved the treatment target of <130/80 mmHg compared with 30% in the control group (p-value = 0.001; RR = 2.33; NNT = 2.50). In addition, the experimental group had significantly higher adaptation scores across all four modes of Roy’s Adaptation Theory compared with the control group (p-value < 0.001). Participants also reported a very high level of satisfaction with the program (Mean = 4.60, S.D. = 0.40). Therefore, the case management medication adherence promotion program based on Roy’s Adaptation Theory combined with digital support through the Line application was effective in improving medication adherence, reducing blood pressure, and enhancing holistic adaptation among patients with uncontrolled hypertension. The program should be applied in primary healthcare services and extended to the management of other chronic diseases.

Effects of a Self-Management Program on Slowing the Progression of Stage 3 Chronic Kidney Disease in the Primary Care Network of Mueang Chi Health Promoting Hospital, Mueang Lamphun District, Lamphun Province, Thailand

2026-04-27T15:35:08+07:00

This quasi-experimental study employed a one-group pretest–posttest design to compare the mean knowledge scores, self-management behavior scores, and estimated glomerular filtration rate of patients with stage 3 chronic kidney disease before and after participation in a self-management program. The sample consisted of 40 patients with stage 3 CKD and comorbid diabetes mellitus and/or hypertension who received care at the chronic disease clinic of the Primary Care Network, Mueang Chi Health Promoting Hospital, Lamphun Province, Thailand. Participants were selected using simple random sampling. The research intervention was a self-management program developed based on the Self-Management Concepts of Kanfer and Gaelick-Buys integrated with the 5A Behavior Change Model for Self-Management Support. Data collection instruments included a CKD knowledge questionnaire and a self-management behavior assessment questionnaire. Data were analyzed using descriptive statistics, and pretest–posttest comparisons were performed using the paired t-test.

The results showed that after participating in the self-management program, the participants’ mean knowledge score significantly increased from 19.85 (S.D. = 2.49) to 21.90 (S.D. = 2.59), and the mean self-management behavior score significantly increased from 68.72 (S.D. = 14.91) to 77.60 (S.D. = 7.79) (p-value < 0.001). However, no statistically significant difference was found in the mean estimated glomerular filtration rate (eGFR) before and after participation in the program (p-value = 0.14). These findings indicate that the self-management program effectively improved knowledge and self-management behaviors among patients with stage 3 CKD. Although no significant change in eGFR was observed during the 12-week intervention period, the program may serve as a useful approach for enhancing nursing services and chronic kidney disease management in primary care settings by promoting patients’ self-management capabilities.

Factors Influencing Infection Prevention and Control Behaviors Among Registered Nurses

2026-04-27T15:40:31+07:00

This predictive correlational study aimed to examine the level of infection prevention and control behaviors and the factors influencing these behaviors among registered nurses. The sample consisted of 135 registered nurses working at Vajira Hospital, selected through multistage sampling. The research instrument was a set of questionnaires comprising demographic information, perceived susceptibility, perceived severity, perceived benefits, perceived self-efficacy, cues to action, health literacy, and infection prevention and control behaviors. Data were analyzed using descriptive statistics, and predictive factors were analyzed using stepwise multiple regression analysis.

The results showed that most registered nurses demonstrated a very high level of infection prevention and control behaviors, accounting for 87.41%. Stepwise multiple regression analysis revealed that health literacy (ß=0.47), cues to action (ß=0.24), and perceived benefits (ß=0.16) jointly predicted infection prevention and control behaviors among registered nurses, explaining 55.70% of the variance (R² = 0.55, Adjusted R² = 0.54, F = 54.90, p-value < 0.001). These findings can be used as a guideline for designing innovations or programs to promote infection prevention and control behaviors among registered nurses by enhancing health literacy, establishing clear cues to action, and strengthening perceived benefits of adherence to standard practices.

Development of a Participatory Model for Promoting Early Childhood Development by Grandparent Caregivers: A Case Study of Huai Yang Kham Child Development Center, Chun District, Phayao Province

2026-03-02T13:05:24+07:00

This action research aimed to develop a participatory model for promoting early childhood development among grandparents at Huai Yang Kham Child Development Center, Chun District, Phayao Province. The participants consisted of two groups: 1) a model development group comprising seven stakeholders, including a child development center teacher, representatives from the local administrative organization, a subdistrict health-promoting hospital, village health volunteers, and grandparents; and 2) an implementation group consisting of 20 grandparents serving as primary caregivers of children from skipped-generation families. The research instruments included: 1) a participatory model for promoting early childhood development among grandparents, 2) a semi-structured interview guide exploring the current situation of grandparents' practices in promoting child development, and 3) a questionnaire assessing grandparents' child development promotion behaviors. Qualitative data were analyzed using content analysis, while quantitative data were analyzed using descriptive statistics and the paired t-test.

The results indicated that the developed participatory model for promoting early childhood development among grandparents was comprised of 4 activities: 1) surveillance and promotion of child development using the Developmental Surveillance and Promotion Manual (DSPM); 2) providing caregivers with knowledge and skills about developmental promotion; 3) monitoring of child development; and 4) developing a system for referring children who are suspected of developmental delays. An evaluation of the implementation of the grandparent-participatory model for promoting early childhood development revealed a statistically significant difference (p-value < 0.01) in the average scores of grandparents’ child-development-promoting behaviors prior to and post-implementation. Findings suggest that healthcare professionals can apply this model to promote early childhood development in skipped-generation families through the encouragement of grandparents' participation and effectively screening and referring children suspected of developmental delays.

Management of Compassion Fatigue among Nurses

2026-03-23T14:19:03+07:00

This article proposes strategies to prevent compassion fatigue among nurses. Currently, nurses are continuously exposed to work-related stress, which leads to both mental and physical health problems. Compassion fatigue is one of the outcomes of working under pressure and continuous exposure to patients’ suffering. It has been found that nurses experience compassion fatigue at prevalence rates exceeding 50%, with levels ranging from low to high. This condition not only affects attitudes toward the profession and quality of work life but also increases turnover intention and impacts patient safety and quality of care. Studies indicate that compassion fatigue is associated with long working hours, heavy workloads, lack of organizational support, job characteristics, and insufficient coping skills. Therefore, managing this issue requires systematic implementation at both the individual and organizational levels. Furthermore, promoting compassion satisfaction, a positive feeling derived from helping others. The implementation of these strategies is expected to reduce compassion fatigue, increase job satisfaction, enhance professional commitment, and support nurse retention, ultimately contributing to the long-term sustainability of the healthcare system.